bims-kimdis 2023-04-30 papers

bims-kimdis

Biomed News

on Ketones, inflammation and mitochondria in disease

Issue of 2023–04–30
six papers selected by
Matías Javier Monsalves Álvarez, Universidad de O’Higgins

The Role of a Ketogenic Diet in the Treatment of Dementia in Type 2 Diabetes Mellitus.
Ketogenic diet in therapy of bipolar affective disorder - case report and literature review.
Is Losing Weight Worth Losing Your Kidney: Keto Diet Resulting in Renal Failure.
Ketogenic diet in children and adolescents: The effects on growth and nutritional status.
Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery.
Effect of a Ketogenic Medium Chain Triglyceride-Enriched Diet on the Fecal Microbiota in Canine Idiopathic Epilepsy: A Pilot Study.

Nutrients. 2023 Apr 19. pii: 1971. [Epub ahead of print]15(8):

The Role of a Ketogenic Diet in the Treatment of Dementia in Type 2 Diabetes Mellitus.

Lin Bai, Yue Zhou, Jie Zhang, Junpeng Ma.

  Type 2 diabetes mellitus (T2DM) shares a common molecular mechanism and underlying pathology with dementia, and studies indicate that dementia is widespread in people with T2DM. Currently, T2DM-induced cognitive impairment is characterized by altered insulin and cerebral glucose metabolism, leading to a shorter life span. Increasing evidence indicates that nutritional and metabolic treatments can possibly alleviate these issues, as there is a lack of efficient preventative and treatment methods. The ketogenic diet (KD) is a very high-fat, low-carbohydrate diet that induces ketosis in the body by producing a fasting-like effect, and neurons in the aged brain are protected from damage by ketone bodies. Moreover, the creation of ketone bodies may improve brain neuronal function, decrease inflammatory expression and reactive oxygen species (ROS) production, and restore neuronal metabolism. As a result, the KD has drawn attention as a potential treatment for neurological diseases, such as T2DM-induced dementia. This review aims to examine the role of the KD in the prevention of dementia risk in T2DM patients and to outline specific aspects of the neuroprotective effects of the KD, providing a rationale for the implementation of dietary interventions as a therapeutic strategy for T2DM-induced dementia in the future.

Keywords:  dementia; ketogenic diet; neuroprotective; type 2 diabetes mellitus

DOI:  https://doi.org/10.3390/nu15081971
Psychiatr Pol. 2022 Dec 31. pii: 136356. [Epub ahead of print]56(6): 1345-1363

Ketogenic diet in therapy of bipolar affective disorder - case report and literature review.

Ireneusz Chmiel.

  Bipolar affective disorder (BPAD) is a chronic mental disorder, characterised by mood swings, alternating between depression and manic or hypomanic episodes. Unfortunately, in some patients pharmacological treatment does not bring satisfactory results, and a certain group of patients shows resistance to treatment. Therefore, other treatment methods are sought after, including a change in diet. The most promising nutrition model is the ketogenic diet. In the presented case study of a male patient, thanks to the introduction of the ketogenic diet, full remission of the disease was achieved, doses of lamotrigine were reduced and quetiapine was completely discontinued. Previously, neither lamotrigine monotherapy nor combined treatment with quetiapine achieved euthymia. The effects of the diet may be related to, among others, the influence on ionic channels and increase in blood acidity (similarly to mood stabilisers), increase in gamma-aminobutyric acid (GABA) concentration, modulation of GABAA receptors and blocking of AMPA receptors by medium-chain fatty acids. The ketogenic diet influences glutamate metabolism and nerve cell metabolism, which uses ketone bodies as energy sources. Ketosis can also stimulate the biogenesis of mitochondria, improve brain metabolism, act as a neuroprotective factor, as well as increase glutathione synthesis and reduce oxidative stress. However, there is a need for carefully planned studies, with an appropriate representative group, to verify the potential benefits and risks of introducing the ketogenic diet in patients with BPAD.

Keywords:  Ketogenic diet; bipolar affective disorder; rapid cycling

DOI:  https://doi.org/10.12740/PP/OnlineFirst/136356
Cureus. 2023 Mar;15(3): e36546

Is Losing Weight Worth Losing Your Kidney: Keto Diet Resulting in Renal Failure.

Girma M Ayele, Rediet Tefera Atalay, Ruth T Mamo, Siham Hussien, Beimnet Nigussie, Abel Fissha, Miriam B Michael.

  Keto diet is defined as a high-fat, adequate-protein, and low-carbohydrate nutrition which forces the body to burn fats and use an alternative metabolic fuel resource by stimulating endogenous ketone production. The standard range of ketones in ketosis is up to 3.00mmol/L, and anything beyond this level can result in serious medical conditions. This diet's most common and easily reversible consequences are constipation, low-grade acidosis, hypoglycemia, kidney stones, and increased lipid in the blood. We present a case of a 36-year-old female who presented with pre-renal azotemia after starting a keto diet regimen.

Keywords:  keto diet; keto diet and acute kidney injury; ketogenic diet; low carbohydrate diet; renal failure; weight loss

DOI:  https://doi.org/10.7759/cureus.36546
Pharmacol Res. 2023 Apr 22. pii: S1043-6618(23)00136-6. [Epub ahead of print]191 106780

Ketogenic diet in children and adolescents: The effects on growth and nutritional status.

Antonio Corsello, Chiara Maria Trovato, Elisabetta Di Profio, Sabrina Cardile, Cristina Campoy, Gianvincenzo Zuccotti, Elvira Verduci, Antonella Diamanti.

  The ketogenic diet is known to be a possible adjuvant treatment in several medical conditions, such as in patients with severe or drug-resistant forms of epilepsy. Its use has recently been increasing among adolescents and young adults due to its supposed weight-loss effect, mediated by lipolysis and lowered insulin levels. However, there are still no precise indications on the possible use of ketogenic diets in pediatric age for weight loss. This approach has also recently been proposed for other types of disorder such as inherited metabolic disorders, Prader-Willi syndrome, and some specific types of cancers. Due to its unbalanced ratio of lipids, carbohydrates and proteins, a clinical evaluation of possible side effects with a strict evaluation of growth and nutritional status is essential in all patients following a long-term restrictive diet such as the ketogenic one. The prophylactic use of micronutrients supplementation should be considered before starting any ketogenic diet. Lastly, while there is sufficient literature on possible short-term side effects of ketogenic diets, their possible long-term impact on growth and nutritional status is not yet fully understood, especially when started in pediatric age.

Keywords:  Childhood obesity; Drug-resistant epilepsy; Ketogenic diet; Micronutrient supplementation; Nutritional status; Pediatric growth; Weight-loss

DOI:  https://doi.org/10.1016/j.phrs.2023.106780
Nutrients. 2023 Apr 14. pii: 1907. [Epub ahead of print]15(8):

Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery.

Luigi Barrea, Ludovica Verde, Luigi Schiavo, Gerardo Sarno, Elisabetta Camajani, Antonio Iannelli, Massimiliano Caprio, Vincenzo Pilone, Annamaria Colao, Giovanna Muscogiuri.

  Bariatric surgery is currently the most effective method for achieving long-term weight loss and reducing the risk of comorbidities and mortality in individuals with severe obesity. The pre-operative diet is an important factor in determining patients' suitability for surgery, as well as their post-operative outcomes and success in achieving weight loss. Therefore, the nutritional management of bariatric patients requires specialized expertise. Very low-calorie diets and intragastric balloon placement have already been studied and shown to be effective in promoting pre-operative weight loss. In addition, the very low-calorie ketogenic diet has a well-established role in the treatment of obesity and type 2 diabetes mellitus, but its potential role as a pre-operative dietary treatment prior to bariatric surgery has received less attention. Thus, this article will provide a brief overview of the current evidence on the very low-calorie ketogenic diet as a pre-operative dietary treatment in patients with obesity who are candidates for bariatric surgery.

Keywords:  bariatric surgery; ketogenic diet; nutrition; obesity; very low-calorie ketogenic diet

DOI:  https://doi.org/10.3390/nu15081907
Vet Sci. 2023 Mar 24. pii: 245. [Epub ahead of print]10(4):

Effect of a Ketogenic Medium Chain Triglyceride-Enriched Diet on the Fecal Microbiota in Canine Idiopathic Epilepsy: A Pilot Study.

Sylvia García-Belenguer, Laura Grasa, Jorge Palacio, Jon Moral, Belén Rosado.

  Ketogenic diets have been successfully used in people and dogs with idiopathic epilepsy. This study examined the effect of a ketogenic medium chain triglycerides (MCT)- enriched diet administered for one month on the fecal microbiota of epileptic (n = 11) (six with drug-sensitive epilepsy, DSE; five with drug-refractory epilepsy, DRE) and non-epileptic beagle dogs (n = 12). A significant reduction after diet in the relative abundance of bacteria from the Actinobacteria phylum was observed in all dogs. Epileptic dogs showed a higher relative abundance of Lactobacillus compared with non-epileptic dogs at baseline but these differences disappeared after diet. Epileptic dogs also showed a significantly higher abundance of Negativicutes and Selenomonadales after dietary intervention. Baseline microbiota patterns were similar in non-epileptic beagles and dogs with DSE but significantly different from dogs with DRE. In non-epileptic and DSE groups, the MCT diet decreased the relative abundance of Firmicutes and increased that of Bacteroidetes and Fusobacteria, but the opposite effect was observed in dogs with DRE. These results suggest that the MCT diet effect would depend on individual baseline microbiota patterns and that ketogenic diets could help reduce gut microbiota differences between dogs with DRE and DSE.

Keywords:  dog; epilepsy; ketogenic diet; medium chain triglycerides; microbiota

DOI:  https://doi.org/10.3390/vetsci10040245